A nurse on a hospice unit is caring for a client who has cancer and is in the active phase of dying. Which of the following findings requires intervention by the nurse?

An assistive personnel is encouraging intake of oral fluids.

Supplemental oxygen is in use.

Benzodiazepines are administered every 4 hr.

A family member remains at the client's bedside 24 hr each day.

Answer and Explanation

The Correct Answer is A

A. An assistive personnel is encouraging intake of oral fluids: For a client in the active dying phase, forcing or encouraging oral intake can cause discomfort, aspiration, or fluid overload. The focus should be on comfort rather than meeting standard hydration goals, so this requires intervention by the nurse.

B. Supplemental oxygen is in use: Oxygen may be provided for comfort if the client experiences dyspnea. Its use in the active dying phase is appropriate and does not require intervention unless it causes discomfort or is unnecessary.

C. Benzodiazepines are administered every 4 hr: Scheduled benzodiazepines can help manage anxiety, restlessness, or dyspnea in a dying client. This is an appropriate intervention for comfort and does not require nurse intervention.

D. A family member remains at the client's bedside 24 hr each day: Continuous presence of family provides emotional support and comfort for both the client and loved ones. This is consistent with hospice care principles and does not require nurse intervention.

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Correct Answer is D

Explanation

A. Waste containers are lined with single bags: Using single-lined waste containers is standard practice and does not pose a significant infection risk. Properly contained waste helps maintain cleanliness and reduce exposure to pathogens.

B. Dampened cloths are used for dusting the area: Using dampened cloths prevents dust from becoming airborne and spreading microorganisms. This method reduces the risk of infection and is appropriate for immunocompromised clients.

C. Uncapped sharps are put in a puncture-resistant container: Sharps should always be capped or handled carefully, but placing them directly in a puncture-resistant container is safe and prevents needlestick injuries.

D. Soiled linens are placed on the floor: Placing soiled linens on the floor exposes them to environmental pathogens and increases the risk of cross-contamination. For immunocompromised clients, proper handling and containment of soiled linens are critical to prevent infection.

A. Make a schedule of daily tasks. B. Have several family members visit daily. C. Limit the use of familiar objects. D. Ask questions that require more than one answer.

Correct Answer is A

Explanation

A. Make a schedule of daily tasks: Establishing a consistent daily routine helps reduce confusion and frustration in clients with Alzheimer's disease. Predictable schedules provide structure, promote independence, and create a sense of security.

B. Have several family members visit daily: While social interaction is important, having too many visitors at once or a constant rotation of people can lead to overstimulation. For a client with Alzheimer's, high-stimulus environments often trigger agitation, confusion, or "sundowning.

C. Limit the use of familiar objects: Surrounding the client with meaningful items—such as family photos, a favorite chair, or personal mementos—helps with reorientation and provides emotional comfort. Removing these objects can increase the client's sense of isolation and disorientation, leading to greater frustration.

D. Ask questions that require more than one answer: Complex questions may be difficult for the client to answer, potentially causing frustration. Simple, clear questions are more appropriate to promote communication and reduce stress.

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A nurse on a hospice unit is caring for a client who has cancer and is in the active phase of dying. Which of the following findings requires intervention by the nurse?

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